Computed Tomographic Assessment of Age- and Gender-Specific Sagittal Lumbopelvic Alignment in a Japanese Population.

INTRODUCTION: Previous studies have reported differences in lumbopelvic alignment between standing and supine positions. Computed tomography (CT) images taken in the supine position are often used for clinical studies in addition to standing radiographs, although not frequently. Our study aims to clarify normative values of CT-evaluated lumbopelvic parameters and the characteristics of age- and gender-related lumbopelvic alignment in the supine position. METHODS: Patients undergoing CT scans of abdominal or lumbar regions for reasons other than low back disorders were included (n=581). Sagittal multiplanar reconstruction CT images were obtained, and lumbar lordosis (LL), L5-S1 angle, and sacral slope (SS) were measured. Mean values of the parameters in patients aged 59 years and under, 60-69, 70-79, and 80 and over, and in males and females, were calculated. Age- and gender-related differences in these parameters were statistically analyzed. RESULTS: Among the four age groups, patients 80 years and over showed significantly lower LL and SS than patients aged 70-79. Females 80 years and over showed significantly lower LL and SS than all other age groups, but those in males did not. The comparison between males and females showed no significant differences in LL and SS; however, the L5-S1 angle was significantly higher in males than in females. In patients 80 years and over, females showed significantly lower LL and SS than in males. CONCLUSIONS: This study provides normative CT-evaluated lumbopelvic parameters, such as LL, L5-S1 angle, and SS, which will be utilized for comparisons in future studies. The present study first revealed that pelvic retroversion and lumbar kyphosis occur in elderly females in the supine position, which raised a possibility that age-related decrease of LL and SS in females occurs at an older age in the supine position than in the standing position.

Functional Assessment of Lumbar Nerve Roots Using Coronal-plane Single-shot Turbo Spin-echo Diffusion Tensor Imaging.

We investigated the usefulness of diffusion tensor imaging using single-shot turbo spin-echo sequence (TSE-DTI) in detecting the responsible nerve root by multipoint measurements of fractional anisotropy (FA) values. Five patients with bilateral lumbar spinal stenosis showing unilateral neurological symptoms were examined using TSE-DTI. In the spinal canal, FA values in the symptomatic side were lower than those in the asymptomatic side. TSE-DTI using multipoint measurements of FA values can differentiate the responsible lumbar nerve root.

Quantitative Assessment of Tendon Healing by Using MR T2 Mapping in a Rabbit Achilles Tendon Transection Model Treated with Platelet-rich Plasma.

PURPOSE: To determine if magnetic resonance (MR) imaging T2 mapping can be used to quantify histologic tendon healing by using a rabbit Achilles tendon transection model treated with platelet-rich plasma (PRP). MATERIALS AND METHODS: Experiments were approved by the Institutional Animal Care and Use Committee. The Achilles tendons of 24 New Zealand white rabbits (48 limbs) were surgically transected, and PRP (in the test group) or saline (in the control group) was injected into the transection site. The rabbits were sacrificed 2, 4, 8, and 12 weeks after surgery. Thereafter, T2 mapping and histologic evaluations were performed by using the Bonar scale. A mixed-model multivariate analysis of variance was used to test the effects of time and PRP treatment on the T2 value and Bonar grade, respectively. The correlation between the T2 value and Bonar grade was also assessed by using the Spearman correlation coefficient. RESULTS: The Bonar scale values decreased in both groups during tendon healing. The T2 value also shortened over time (P < .001 for both groups). The T2 values were positively correlated with the Bonar grade (ρ = 0.78, P < .001). Both the T2 value and Bonar scale value were lower in the PRP group than in the control group at 4, 8, and 12 weeks; however, there was no significant effect of PRP treatment on the T2 value or Bonar grade. CONCLUSION: The T2 value changes reflected histologic tendon healing. While T2 and Bonar grade were lower at all time points in tendons treated with PRP, there was no significant difference between the treatment and control tendons.

Comparison of MRI-based assessment systems for osteoarthritic knees: the irregularity index system and WORMS.

PURPOSE: Several MRI-based evaluation systems for osteoarthritis (OA) of the knee have been developed. Among them the whole-organ magnetic resonance imaging score (WORMS), which evaluates the status of the entire knee joint, appears to be representative. We developed an irregularity index system to measure irregularities of the contours of the femoral condyle on MRI. Only the contour of the condyle was assessed by the irregularity index, whereas several items comprising the knee joint were taken into account by WORMS. This study compared the irregularity index and WORMS in terms of their correlations with clinical scores. METHODS: Thirty-one medial-type OA knees were studied. Kellgren-Lawrence grading was used for X-ray grading: 8 were grade II, 11 were grade III, and 12 were grade IV. Japanese Orthopaedic Association scores and Japanese knee osteoarthritis measure scores were used for clinical assessments. We determined the correlations between MRI-based assessment scores and clinical scores. RESULTS: Both the irregularity index and WORMS exhibited positive correlations with these clinical scores. The irregularity index was associated with bone cysts of the medial compartment and menisci in the articular features of WORMS. CONCLUSIONS: These MRI-based methods are useful for evaluating OA severity. However, the irregularity index may have advantages over WORMS because of its semi-automatic features.

The development of a three-dimensional T1 image calculation program in proportion to the DICOM data of any marketing clinical MRI systems.

Contrast media such as gadolinium-diethlene-triamine pentaacetic acid (Gd-DTPA) is used for MRI. Recently there have been some reports about diagnosis using contrast media for the MRI T(1) image for the quantitative evaluation of articular cartilage degeneration. This may be a useful method to evaluate the lesion of the articular cartilage or to confirm therapeutic progress. Whether or not contrast is used, the use of the calculated T(1) image is effective for the quantitative evaluation of the degeneration of knee joint cartilage. However, our system copes with the format of every MRI image even if software of the calculated T(1) image isn't often prepared in the commercial MRI device. So, we developed general purpose image data processing software that can be processed on the preexisting three-dimensional image data processing system.